Joint Pain in Relation to Body Composition and Sedentary Behaviours Post-Bariatric Surgery

Transcription

1 Joint Pain in Relation to Body Composition and Sedentary Behaviours Post-Bariatric Surgery Nathan A. Chiarlitti 1, Alexandra Sirois 1, Ryan E. Reid 1, Kathleen M. Andersen 1, Nicholas V Christou 1, Ross E Andersen 1, Susan J. Bartlett 1 1 McGill University

2 Introduction u What s been said u Importance of: u Body composition u Sedentary time

3 Body Fat and Pain u Release of cytokines 1 u Affect joint structure 1 1 Brady, Mamuaya et al. (2015). Body Composition is Associated With Multisite Lower Body Musculoskeletal Pain in a Community-based Study. Journal of Pain.

4 Body Fat and Pain u Related to musculoskeletal pain 1,2 u Pain improvement with surgery 2 1Yoo, Cho, Lim, Kim. (2014). Relationships Between Body Mass Index, Fat Mass, Muscle Mass, and Musculoskeletal Pain in Community Residents. ACR. 2 Brady, Mamuaya et al. (2015). Body Composition is Associated With Multisite Lower Body Musculoskeletal Pain in a Community-based Study. Journal of Pain.

5 Sedentary Behaviours and Pain u Reclined posture, sitting, laying down 1 u Risk factor associated with obesity, type II diabetes 2 u Obese individuals and high amounts of sitting time 2 1 Sedentary Behaviour Research Network. Standardized use of the terms sedentary and sedentary behaviours. Appl Physiol Nutr Metab 2012; 37: Herman, K.M., Carver, T.E., Christou, N.V. and Andersen, R.E., Physical activity and sitting time in bariatric surgery patients 1 16 years post-surgery. Clinical obesity, 4(5), pp

6 Sedentary Behaviours and Pain u Prolonged sitting leads to back pain 1 Pain Sedentary Behaviours Obesity 1 Beach TA, Parkinson RJ, Stothart JP, et al. Effects of prolonged sitting on the passive flexion stiffness of the in vivo lumbar spine. Spine J 2005;5:

7 Treating Obesity

8 Bariatric Surgery u Benefits u Physical function 1 u Improvements in pain 1,2 1 King, Chen, Belle et al. (2017). Change in Pain and Physical Function Following Bariatric Surgery for Sever Obesity. JAMA. 2 Groen, van de Graaf, Scholtes et al. (2014). Effects of bariatric surgery for knee complaints in obese adult populations: A systematic review. Obesity Reviews.

9 Purpose u To explore how body composition changes, particularly body fat, relates to hip, knee and other joint pain u To explore how sedentary hours relates to hip, knee and other joint pain

10 Methods u Secondary analysis from a convenience sample u Participants u 167 adults (118 females) u Underwent bariatric surgery 1-17 years prior

11 Body Composition u DXA scan completed at follow-up u Body Fat Percentage u Lean Tissue Mass u Bone Mineral Density

12 Knee, Hip, and Other Pain* u Pain prior to surgery u Pain post surgery u Worse u Same u Better *low back, feet, etc.

13 Sedentary Time u How many hours per day do you spend sitting or lying down, not including sleeping?

14 Statistical Analysis u t-tests were used to compare differences in pain (Improved or Same/Worse) in relation to: u Weight change u % Regain u Body Fat % u Hours sedentary per day

15 Participant Characteristics (n=167) Variable Mean ± SD Age 51 ± 10 Follow-up (years) 9 ± 4 Change in Weight (kg) 49.3 ± 29.3 Weight Regain 23% Knee Pain 46% Hip Pain 19% Other Pain 47% Sedentary Hours per day 7 ± 3

16 weight loss = pain Weight (kg) **p =.08 ** * Knee Hip Other Improved Same/Worse

17 regain = pain % Regain * Knee Hip Other Improved Same/Worse

18 Fat % body fat = pain * Knee Hip Other Improved Same/Worse

19 sedentary hours = pain Hours * Knee Hip Other Improved Same/Worse

20 Strengths and Limitations u Strengths u DXA Scan u Sample size u Limitations u Differentiate joint pain u Self-report

21 Conclusions u Body composition and sitting time both relate to joint pain u Improved joint pain related to: u greater reductions in weight u less weight regained u lower body fat u less sedentary hours

22 Clinical Implications u Both weight loss and reducing sedentary time may help improve joint pain symptoms

23 Acknowledgements u Supervisors u Dr. Susan Bartlett u Dr. Ross Andersen u Alex Sirois u Ryan Reid u Patrick Delisle-Houde u Kathleen Andersen u Nicholas Cristou u Tamara Carver

24 Questions

25 Improved Same/Worse Mean Difference (95% CI) P value Hip (n=31) Pre-Surgical Weight (kg) Weight Change (Kg) % Regain Current % Fat Hours sitting per day n=15 (48%) (35.6) (36.1) 18.6 (14.5) 41.5 (8.3) 7.2 (2.8) n=16 (52%) (27.3) (23.5) 22.0 (17.3) 44.0 (8.3%) 8.2 (3.7) 18.9 (-4.3, 42.1) 23.4 (-45.7, -1.2) -3.3 (-15.1, 8.4) -2.5 (-8.6, 3.6) -1.0 (-3.7, 1.6) Knee (n=77) Pre-Surgical Weight (kg) Weight Change (Kg) % Regain Current % Fat Hours sitting per day n=42 (55%) (33.4) (2.7) 18.9 (13.2) 43.2 (8.6) 6.3 (3.3) n=35 (45%) (31.2) (20.2) 25.7 (22.6) 46.3 (8.1) 7.9 (3.0) 2.6 (-12.2, 17.4) (-21.3, 1.1) -6.8 (-15.1, 1.4) -3.2 (-7.0, 0.7) -1.6 (-3.1, -0.0) Back/Other Joints (n=79) I Pre-Surgical Weight (kg) Weight Change (Kg) % Regain Current % Fat Hours sitting per day n=42 (53%) (29.0) (26.6) 17.1 (12.9) 43.1 (8.2) 6.8 (3.7) n=37 (57%) (22.2) (21.6) 28.6 (27.2) 43.6 (8.7) 7.9 (3.7) 0.4 (-11.3, 12.1) -8.0 (-19.0, 3.0) (-20.9, -2.1) -0.5 (-4.3, 3.3) -1.1 (-2.8, 0.7)